TECHNICAL FIELD
[0001] The present disclosure relates to bone cut positioning systems, and more specifically,
to femoral bone cut positioning systems.
[0002] The closest prior art is document
EP 1444957 A1, which defines the preamble of claim 1.
BACKGROUND
[0003] Orthopedic procedures for the replacement of all, or a portion of, a patient's joint
typically require resecting (cutting) or reshaping the ends of the bones forming the
joint. For example, total knee arthroplasty ("TKA") procedures typically include cutting
open the knee, displacing the patella, resecting bone from the distal end of the femur,
resecting bone from the proximal end of the tibia to prepare the joint for prosthetic
femoral and tibial implant components. Resecting the distal end of the femur often
involves making one or more cuts including a planar distal cut. Resecting the proximal
end of the tibia often involves making a planar proximal cut. In view of the foregoing
surgical steps, TKA procedures are invasive, but typically effective.
[0004] TKA procedures can be complicated by the fact that a mechanical axis of the leg does
not typically line up with the anatomic axis or intramedullary canal. The mechanical
axis includes a line from the center of a proximal joint to a distal joint of a long
bone (e.g., femur or tibia), such that the mechanical axis is straight as it is a
direct path between joint centers. The intramedullary generally follows the curvature
of the femur, such that it is not straight as compared to mechanical axis.
[0005] Cut guides can be used to guide a saw and achieve the proper angle and position of
the cuts performed during a TKA. Cut guides can be in the form of a guide member having
slots therein for receiving and guiding the saw. In use, the guide member can be positioned
against the bone with the assistance of positioning or alignment equipment. The proper
positioning of such guide members is crucial to forming well-positioned bone cuts
for attachment of the prosthetic femoral and tibial implant components. For example,
the tibial cut affects spacing, alignment and balance between the tibia and femur
when the knee is in flexion, and alignment and balance between the tibia and femur
when the knee is in extension, as well as all points of articulation between extension
and flexion. Once properly positioned and aligned, the guide member can be secured
to the bone using bone pins or other securement means. For example, the guide member
can be slidably mounted to an alignment guide, which can be mounted at an angle relative
to an extramedullary guide or intramedullary rod. For an extramedullary tibial resection,
an extramedullary guide can be located relative to the patient's anatomy to provide
proper alignment relative to the tibia, and a guide member can be positioned on the
proximal end of the tibia. Similarly, in an intramedullary tibial resection, an intramedullary
rod can be inserted into a pre-drilled hole in the intramedullary canal of the tibia
to provide anatomic alignment with a cut guide positioned on the proximal end of the
tibia. For preparation of the femoral resection, an intramedullary rod can be positioned
such that it extends across the distal end of the femur, and the cut guide can be
positioned on the proximal end of the femur. The cut guide can be slid toward or away
(medially-laterally) from the tibia or femur until it is properly positioned against
the surface of the bone. The cut guide can then be secured to the bone with pins.
The cut guide can be connected to the alignment guide using a pin/hole connect mechanism.
SUMMARY
[0006] The invention is defined in claim 1.
[0007] Examples included in the present disclosure can provide the benefit of reducing errors
that can occur from intramedullary techniques, such as an error in varus-valgus alignment.
That is, the present disclosure can provide a more accurate extramedullary technique.
Further benefits of the present disclosure can include a system or method of resecting
a femur such that the amount of bone cut from the femur is substantially minimized.
Benefits of the present disclosure can also include providing a resected fixation
surface that provides an improved or more secure fit for TKA prosthetics, as compared
to previous approaches. Further, the present disclosure can provide a system and method
for use in a TKA or partial knee replacement procedure while a leg is in extension.
Benefits of such examples can include providing a better overall alignment analysis
for a surgeon. Further, the system can include a more stable femoral attachment member
better suited for procedures on a leg in extension. In addition, the present disclosure
can provide an extramedullary system or method that is less invasive than an intramedullary
technique, thereby reducing potential for infection and recovery time for a patient.
Further, because the examples of the present disclosure provide extramedullary techniques
that do not require intramedullary rod insertion, risk of systemic embolism is substantially
reduced. Examples described in the present disclosure can be used when extra-articular
deformities exist or when existing hardware, such as an extended hip stem, makes an
intramedullary technique difficult.
BRIEF DESCRIPTION OF THE DRAWINGS
[0008] In the drawings, which are not necessarily drawn to scale, like numerals may describe
similar components in different views. Like numerals having different letter suffixes
may represent different instances of similar components. The drawings illustrate generally,
by way of example, but not by way of limitation, various examples discussed in the
present document.
FIG. 1 is a perspective view of a positioning assembly, in accordance with at least
one example;
FIG. 2 is a perspective view of the positioning assembly and an attached light emitter,
in accordance with at least one example;
FIG. 3 is a perspective view of the positioning assembly engaged with a femur, in
accordance with at least one example;
FIG. 4A is a top view of the positioning assembly and the lighter emitter engaged
with the femur, in accordance with at least one example;
FIG. 4B is an alternative top view of the positioning assembly and the light emitter
engaged with the femur, in accordance with at least one example;
FIG. 5 is an alternative perspective view of the bone cut positioning system and the
light emitter engaged with the femur, in accordance with at least one example;
FIG. 6 is a perspective view of a guide member, in accordance with at least one example;
FIG. 7 is a perspective view of the positioning assembly and the guide member, which
together form a bone cut positioning system, in accordance with at least one example;
and
FIG. 8 is a perspective view of a cut guide engaged with the femur, in accordance
with at least one example.
FIG. 9 is a method for positioning a cut guide on a femur, in accordance with at least
one example.
DETAILED DESCRIPTION
[0009] The present disclosure describes a bone cut positioning system and related method
of use. The bone cut positioning system and methods can be used in various examples
to enhance or facilitate a total knee arthroplasty (TKA) procedure, a partial knee
arthroplasty procedure, or any other suitable knee surgery procedure in which one
or more cuts are made on a femur, such as a distal end of the femur. Generally, the
examples described herein provide a means for positioning a bone cut on a femur. Although
the following description focuses on TKA procedures, the described examples can also
be used for partial knee arthroplasty procedures or other knee procedures in which
femoral bone cuts are made.
[0010] FIG. 1 is a perspective view of a positioning assembly 10 in accordance with the
present disclosure. One or more of the components of the positioning assembly 10 can
be made of a biocompatible material, such as a material that does not produce a toxic,
injurious, or immunological response in living tissue. Biocompatible materials can
include, but are not limited to, ceramics, synthetic polymeric materials, and metallic
materials such as titanium, a titanium alloy, cobalt chromium, cobalt chromium molybdenum,
tantalum, or a tantalum alloy. In various examples, the positioning assembly 10 can
be made of stainless steel. In various examples, the positioning assembly 10 can be
reusable, such as after sterilization.
[0011] As illustrated in FIG. 1, the positioning assembly 10 can include a femoral attachment
member 2 configured to be fixed to a distal end of a femur, a light emitter mounting
member 12, a channel 16 configured to receive a depth selector slide, and a varus-valgus
adjustment member 20.
[0012] The femoral attachment member 2 includes a first tongue 4 with at least one fixation
aperture 6 configured to receive a pin or other fastening member. In various examples,
the first tongue 4 is configured such that it provides a reference on a medial or
lateral side on an anterior cortex of the femur, when secured to the femur. The reference
provided by the first tongue 4 can also be a flexion-extension axis reference. The
first tongue 4 can include a substantially flat surface 5 configured to be secured
to the anterior cortex of the femur. As illustrated in FIG. 1, the femoral attachment
member 2 can include a second tongue 7 with at least one fixation aperture 8 configured
to receive a pin or other fastening member for securing the femoral attachment member
2 to the distal end of the femur. In an example, the at least one fixation aperture
can be oriented and positioned such that it provides a fixation point into the distal
trochlea of the femur. The at least one fixation aperture 8 and corresponding pin
or fastening member can be configured to provide stability to the positioning assembly
10 such that an intramedullary rod is not necessary, therefor decreasing invasiveness
of the procedure.
[0013] The light emitter mounting member 12 is configured to receive one or more light emitters.
As illustrated in FIG. 1, the light emitter mounting member 12 can include a light
emitter receiving hole 14 configured to receive at least a portion of a light emitter.
The light emitter mounting member 14 can be disposed at any suitable position, such
as above the femoral attachment member 2 when the femoral attachment member 2 is secured
to the distal end of the femur. In an example, the light emitter mounting member 14
is configured such that the light emitter, when mounted, is substantially centered
medially and laterally on the femur and perpendicular to a cutting plane, as described
herein.
[0014] As described above, the channel 16 is configured to receive a depth selector slide.
In an example, the channel 16 can include a magnetic interface 18 configured for magnetically
securing the light emitter to the light emitter mounting member 12. That is, in various
examples, the depth selector slide, as described herein, can be magnetically coupled
to the channel 16. A guide member can also be provided that is configured to extend
from the depth selector slide, as described in further detail below.
[0015] The varus-valgus adjustment member 20 is configured to adjust a position of the positioning
assembly 10 relative to the femur to achieve a desired varus-valgus angle. In an example,
the varus-valgus adjustment member 20 can be a screw that is configured to receive
an adjustment device. For example, an adjustment device can include a screw driver,
an Allen wrench, or any other suitable device that is capable of turning the varus-valgus
adjustment member 20. The positioning assembly 10 can further include a flexion-extension
indicator 22 configured to indicate an angle of a knee joint. Additional details of
the structure and operation of the varus-valgus adjustment member 20 are described
below in connection with FIGS. 4A and 4B.
[0016] FIG. 2 is an alternate perspective view of the positioning assembly 10 including
a light emitter 26. In various examples, the light emitter 26 can be movable by a
user, such that it can tilt relative to the positioning assembly 10. The light emitter
26 can generally include a light source configured to emit a light beam, as described
herein. A light source can include, for example, a light emitting diode, a laser,
or a combination thereof. In various examples, the light emitter 26 can emit a light
beam in more than one direction, such as longitudinally along at least a portion of
the femur and the tibia. The light emitter 26 can include a light emitter protrusion
13 configured to be received by light emitter receiving hole 14 (see FIG. 1) of the
light emitter mounting member 12. The engagement between the light emitter 26 and
the light emitter mounting member 12 can be configured to allow tilting of the light
emitter 26 by the user to allow adjustment of the light beam along the femur and/or
the tibia. Although the light emitter receiving hole 14 is shown as cylindrical in
FIG. 1, it can be any three-dimensional geometric shape capable receiving the light
emitter protrusion 13. Thus, the light emitter receiving hole 14 and the light emitter
protrusion 13 can be defined by a similar three-dimensional shape, or non-similar
three-dimensional shapes that allow for engagement between the light emitter protrusion
13 and the light emitter receiving hole 14. Alternatively, the light emitter 26 can
be fixed, such as an integral assembly, with the positioning assembly 10.
[0017] The light emitter 26 can be configured to emit a light upon being coupled to the
light emitter mounting member 12. For example, the lighter emitter 26 can include
a magnetic switch that activates or powers on the light source upon being coupled
to the light emitter mounting member 12. Alternatively or in addition, the light emitter
26 can include a manual on/off switch. For example, the light emitter 26 can include
a switch that can be activated when exposed to the magnetic force of the light emitter
mounting member 12. Additionally or alternatively, the light emitter can include a
switch operable by a user to activate the light source.
[0018] As further illustrated in FIG. 2, the positioning assembly 10 includes a flexion-extension
adjustment member 24. The flexion-extension adjustment member 24 is configured to
adjust the positioning assembly 10 to achieve a desired flexion-extension of a knee
joint, as described herein.
[0019] FIG. 3 is a perspective view of the positioning assembly 10 engaged with a femur
30. As shown, a pin 28 inserted into the distal trochlea of the femur 30 can provide
stability for the positioning assembly 10. Pins 28 can also be positioned within the
fixation apertures 6 of the first tongue 4 to secure the femoral attachment member
2 to the femur 30.
[0020] FIG. 4A is an alternate perspective view of the positioning assembly 10 engaged with
the femur 30. With reference to FIG. 4A, the varus-valgus adjustment member 20 can
adjust a position of the positioning assembly 10 relative to a varus-valgus angle
or line of the femur 30 or the tibia 32. The varus-valgus adjustment member 20 can
be operable to adjust a position of the light emitter mounting member 12 without adjusting
a position of the femoral attachment member 2. Thus, adjusting the varus-valgus adjustment
member 20 can rotate one or more components of the positioning assembly 10 in a direction
A. In an example, the varus-valgus adjustment member 20 can be configured to rotate
the light emitter mounting member 12 or light emitter 26 clockwise or counter clockwise
relative to the femoral attachment member 2.
[0021] As shown in FIG. 4B, the light emitter 26 can extend the light beam 34 longitudinally
along at least a portion of the femur 30, the tibia 32, or both the femur 30 and the
tibia 32. More specifically, the light emitter 26 can direct the light beam 34 toward
a surface of the femur 30 or the tibia 32 for guiding orientation or adjustment of
the positioning assembly 10. In various examples, the beam of light 34 can include
a plane, a fan, a cross, or any other suitable light configuration. When the varus-valgus
adjustment member 20 is adjusted, the beam of light 34 can be adjusted in the same
direction A as the positioning assembly 10 or the light emitter mounting member 12,
when the position of the light emitter mounting member 12 is adjusted independently
of and relative to the femoral attachment member 2. The light beam 34 can be adjusted
in the direction A until a desired varus-valgus alignment between the varus-valgus
line of the femur 30 and/or tibia 32 and the positioning assembly 10 is achieved.
[0022] FIG. 5 illustrates another perspective view of the positioning assembly 10 mounted
on the femur 30. With reference to FIG. 5, the flexion-extension adjustment member
24 can adjust the positioning assembly 10 in a direction B. The flexion-extension
indicator 22 can indicate a desired flexion-extension alignment of the positioning
assembly 10 as selected by a user through adjustment of the flexion-extension adjustment
member 24. The flexion-extension indicator 22 can include any suitable type of level
indicator, such as a ball level indicator, a bubble level indicator, or a digital
inclinometer. In operation, the user can manipulate the flexion-extension adjustment
member 24 until a desired flexion-extension angle has been achieved as visually displayed
by the flexion-extension indicator 22. In various examples, the desired flexion-extension
angle can be between 0 degrees and about 5 degrees flexion, although other ranges
are also contemplated. The flexion-extension adjustment member 24 can be adjusted
when the leg is in full-extension, such as when compression is applied to the leg,
or when the leg is in partial flexion.
[0023] FIG. 6 is a perspective view of a guide member 36, such as a pin guide. As illustrated
in FIG. 6, the guide member 36 includes a depth selector slide 38. The depth selector
slide 38 can include a magnetic interface 39 configured to magnetically interact with
the magnetic interface 18 (see FIG. 1) of the channel 16 (see FIG. 1). The depth selector
slide magnetic interface 39 can be configured to contact or be positioned sufficiently
close to the magnetic interface 18 of the channel 16 such that the depth selector
slide 38 can be retained within the channel 16. The magnetic force between the magnetic
interface 39 of the depth selector slide 38 and the magnetic interface 18 of the channel
16 can be strong enough to temporarily fix the depth selector slide 38 within the
channel 16, but weak enough such that a user can reposition remove the depth selector
slide 38 from the positioning assembly 10 by pushing, pulling, or lifting the depth
selector slide 38. In various examples, the guide member 36 can include one or more
apertures 40 configured to receive a pin or other fastening member for securing the
guide member 36 to the femur.
[0024] The guide member 36 can include a femoral contact surface 44 configured to contact
a surface of the distal femur, such as a condyle of the femur. In an example, the
femoral contact surface 44 can be configured to contact a high point of the distal
femur such that a resection depth between about 1 mm and about 20 mm can be determined.
After making contact with the desired portion of the femur, the guide member 36 can
be secured to the femur by inserting one or more pins or other fastening members through
the one or more apertures 40.
[0025] FIG. 7 is a perspective view of the guide member 36 coupled to the positioning assembly
10, which together form a bone cut positioning system 11. As discussed above with
reference to FIG. 3, pins 28 can be inserted through the first tongue 4 and the second
tongue 7 to secure the femoral attachment member 2 to the femur 30. As illustrated
in FIG. 7, pins 46 can also be inserted through the apertures 40 in the guide member
36 to secure the guide member 36 to the femur 30.
[0026] FIG. 8 is a perspective view of a cut guide 48 mounted on the femur 30 after the
bone cut positioning system 11 has been removed from the femur 30. In the example
previously described, the bone cut positioning system 11 can be decoupled from the
femur 30 by removing the pins 28. After removing the pins 28 the bone cut positioning
system 10 can be slid off the femur 30 leaving only the pins 46 engaged with the femur
30. The cut guide 48 can be slid over the pins 46 by inserting the pins 46 within
one or more apertures 47 formed in the cut guide 48. The cut guide 48 can include
one or more cutting surfaces 50, one or more cutting slots 51, or a combination of
such elements. With reference to FIG. 8, the cutting surface 50 and the cutting slots
51 can be configured for guiding a saw or other cutting instrument. In an example,
at least one of the cutting surface 50 and the cutting slots 52 can be oriented along
a plane that is substantially perpendicular to the light beam 34 of FIG. 4B.
[0027] The cut guide 48 can be a single-use, disposable device manufactured from a biocompatible
material, as described herein. As illustrated in FIG. 8, at least a portion of the
biocompatible material forming the cut guide 48 can be a resorbable material, such
as a portion 49 of the cut guide 48 that includes the cutting surface 50 and the cutting
slots 51. A resorbable material can include a material capable of being absorbed into
tissue of a human subject upon separation of the material from the guide member 48.
For example, the resorbable material can include a poly-L-lactide, a poly-D-lactide,
a poly-DL-lactide, a ployglycolide, a polycaprolactone, or a combination thereof.
In an example, the resorbable material portion 49 of the cut guide 48 can be removable
or replaceable, such that the guide member 48 can be reused after sterilization and
replacement of the portion 49.
[0028] FIG. 9 is a method 80 for positioning a bone cut guide on a femur. The method 80
can include coupling 82 a positioning assembly to a femur, including inserting at
least one pin or other fastening member into a distal trochlea of the femur. The positioning
assembly can include a femoral attachment member including a tongue with at least
one fixation aperture configured to receive a pin or other fastening member, a light
emitter mounting member configured to receive a light emitter, a channel configured
to receive a depth selector slide, a varus-valgus adjustment member configured to
adjust a position of the positioning assembly relative to the femur to achieve a desired
varus-valgus angle, a flexion-extension adjustment member configured to adjust a flexion-extension
position of the positioning assembly relative to a flexion-extension of a knee joint,
and a guide member configured to extend from the depth selector slide.
[0029] The method 80 can further include attaching 84 the light emitter to the light emitter
mounting member. Attaching the light emitter to the light emitter mounting member
can further include activating a light source, such as magnetically or by an on/off
switch. Upon activation, the light emitter can be configured to indicate a varus-valgus
angle of the femur.
[0030] In various examples, the method 80 can include sliding 86 a guide member, extending
from the depth selector slide, into the channel of the positioning assembly. A magnetic
interface can be formed between the channel and the depth selector slide, as described
herein. The method 80 can include aligning 88 the guide member relative to a high
point of a distal end of the femur, including touching a contact surface of the guide
member with a high point of the distal femur, as described herein. Aligning 88 can
further include adjusting the depth selector slide to a desired resection level.
[0031] The method 80 can further include coupling 90 the guide member to the femur with
at least one guide pin or other fastening member. Further, the method 80 can include
removing 92 the positioning assembly and the guide member from the femur, and sliding
94 a cut guide over the at least one guide pin.
[0032] In various examples, the method 80 can further include adjusting the varus-valgus
adjustment member to align the positioning assembly with a desired varus-valgus angle
of the femur, such as prior to mounting the guide member. For example, a light beam
emitted by the light emitter can be aligned with a varus-valgus line of the femur
and/or tibia. Further, the method can include adjusting the flexion-extension adjustment
member to align the positioning assembly with a flexion-extension angle of the knee
joint. Adjusting the flexion-extension adjustment member can include adjusting the
flexion-extension member until a flexion-extension indicator indicates the positioning
assembly is substantially level. The method 80 can be performed on the leg in full
extension, such as with applied compression, or when the leg is in partial flexion.
[0033] The above Detailed Description includes references to the accompanying drawings,
which form a part of the Detailed Description. The drawings show, by way of illustration,
specific examples in which the invention can be practiced. These examples are also
referred to herein as "examples." Such examples can include elements in addition to
those shown or described. However, the present inventor also contemplates examples
in which only those elements shown or described are provided. Moreover, the present
inventor also contemplates examples using any combination or permutation of those
elements shown or described (or one or more aspects thereof), either with respect
to a particular example (or one or more aspects thereof), or with respect to other
examples (or one or more aspects thereof) shown or described herein.
[0034] In the event of inconsistent usages between this document and any documents so incorporated
by reference, the usage in this document controls.
[0035] In this document, the terms "a" or "an" are used, as is common in patent documents,
to include one or more than one, independent of any other instances or usages of "at
least one" or "one or more." In this document, the term "or" is used to refer to a
nonexclusive or, such that "A or B" includes "A but not B," "B but not A," and "A
and B," unless otherwise indicated. In this document, the terms "including" and "in
which" are used as the plain-English equivalents of the respective terms "comprising"
and "wherein." Also, in the following claims, the terms "including" and "comprising"
are open-ended, that is, a system, device, article, composition, formulation, or process
that includes elements in addition to those listed after such a term in a claim are
still deemed to fall within the scope of that claim. Moreover, in the following claims,
the terms "first," "second," and "third," etc. are used merely as labels, and are
not intended to impose numerical requirements on their objects.
[0036] The above Detailed Description is intended to be illustrative, and not restrictive.
For example, the above-described examples (or one or more aspects thereof) may be
used in combination with each other. Other examples can be used, such as by one of
ordinary skill in the art upon reviewing the above Detailed Description. Also, in
the above Detailed Description, various features may be grouped together to streamline
the disclosure. This should not be interpreted as intending that an unclaimed disclosed
feature is essential to any claim. Rather, inventive subject matter may lie in less
than all features of a particular disclosed example. The scope of the invention should
be determined with reference to the appended claims.
[0037] The Abstract is provided to allow the reader to quickly ascertain the nature of the
technical disclosure. It is submitted with the understanding that it will not be used
to interpret or limit the scope or meaning of the claims.
1. A bone cut positioning system (11), comprising:
a positioning assembly (10), including:
a femoral attachment member (2) configured to be fixed to a distal end of a femur,
the femoral attachment member including a first tongue (4) with at least one fixation
aperture (6);
a light emitter mounting member (12) configured to receive a light emitter (26); a
channel (16);
a varus-valgus adjustment member (20) configured to adjust a position of the positioning
assembly relative to the femur to achieve a desired varus-valgus angle; and
a flexion-extension adjustment member (24) configured to adjust a flexion-extension
position of the positioning assembly; and
a guide member (36), characterised in that the first tongue is adapted for securement to the anterior cortex of the femur proximal
to the distal end of the femur and in that the guide member is configured to extend from a depth selector slide (38), the depth
selector slide configured to be received within the channel of the positioning assembly,
the guide member comprising at least one femoral contact surface (44), the depth selector
slide configured to move within the channel to move the guide member proximally-distally
relative to the femur to cause the at least one femoral contact surface to engage
the distal end of the femur to determine a desired resection level.
2. The bone cut positioning system of claim 1, wherein the depth selector slide is configured
to be magnetically coupled to the channel.
3. The bone cut positioning system of claim 1, wherein the positioning assembly is manufactured
from at least one biocompatible material.
4. The bone cut positioning system of claim 1, wherein the femoral attachment member
includes a second tongue (7) with at least one fixation aperture (8) configured to
receive a pin (28) for securing the femoral attachment member to the distal end of
the femur, the at least one fixation aperture being oriented and positioned to provide
a fixation point into the distal trochlea of the femur.
5. The bone cut positioning system of claim 1, wherein the light emitter mounting member
includes a light emitter receiving aperture (14) configured to receive at least a
portion of the light emitter.
6. The bone cut positioning system of claim 5, further including a magnetic interface
for magnetically securing the light emitter to the light emitter mounting member.
7. The bone cut positioning system of claim 6, wherein the light emitter comprises a
magnetic switch that is configured to be activated to power on the light emitter when
received by the light emitter mounting member.
8. The bone cut positioning system of claim 1, wherein the light emitter includes a laser
light emitter.
9. The bone cut positioning system of claim 1, wherein the guide member is a single-use,
disposable device.
10. The bone cut positioning system of claim 1, wherein the positioning assembly is reusable.
11. The bone cut positioning system of claim 1, further including a flexion-extension
indicator (22).
12. The bone cut positioning system of claim 11, wherein the flexion-extension indicator
includes a bubble level.
13. The bone cut positioning system of claim 1, wherein at least one of the varus-valgus
and flexion-extension adjustment members is configured to receive an adjustment device.
14. The bone cut positioning system of claim 1, wherein the first tongue is configured
to provide a reference on at least one of a medial and lateral side on the anterior
cortex of the femur.
15. The bone cut positioning system of claim 1, further comprising:
a magnetic interface (18) disposed within the channel, the depth selector slide configured
to be secured within the channel by the magnetic interface.
1. Knochenschnittpositionierungssystem (11), umfassend: eine Positionierungsanordnung
(10), enthaltend:
ein femorales Befestigungselement (2), das dazu ausgelegt ist, an einem distalen Ende
eines Oberschenkelknochens befestigt zu werden, wobei das femorale Befestigungselement
eine erste Zunge (4) mit mindestens einer Befestigungsöffnung (6) enthält;
ein Lichtsendermontageelement (12), das dazu ausgelegt ist, einen Lichtsender (26)
aufzunehmen;
einen Kanal (16);
ein Varus-Valgus-Einstellelement (20), das dazu ausgelegt ist, eine Position der Positionierungsanordnung
relativ zum Oberschenkelknochen einzustellen, um einen gewünschten Varus-Valgus-Winkel
zu erzielen; und ein Beuge-Streck-Einstellelement (24), das dazu ausgelegt ist, eine
Beuge-Streck-Position der Positionierungsanordnung einzustellen; und
ein Führungselement (36), dadurch gekennzeichnet, dass die erste Zunge für die Befestigung an der vorderen Kortikalis des Oberschenkelknochens
proximal zu dem distalen Ende des Oberschenkelknochens angepasst ist und, dass das
Führungselement dazu ausgelegt ist, sich von einem Tiefenwählschieber (38) zu erstrecken,
wobei der Tiefenwählschieber dazu ausgelegt ist, innerhalb des Kanals der Positionierungsanordnung
aufgenommen zu werden, wobei das Führungselement mindestens eine femorale Kontaktfläche
(44) umfasst, wobei der Tiefenwählschieber dazu ausgelegt ist, sich innerhalb des
Kanals zu bewegen, um das Führungselement proximal-distal relativ zum Oberschenkelknochen
zu bewegen, um zu bewirken, dass die mindestens eine femorale Kontaktfläche mit dem
distalen Ende des Oberschenkelknochens in Eingriff tritt, um eine gewünschte Resektionsebene
zu bestimmen.
2. Knochenschnittpositionierungssystem nach Anspruch 1, wobei der Tiefenwählschieber
dazu ausgelegt ist, magnetisch mit dem Kanal gekoppelt zu sein.
3. Knochenschnittpositionierungssystem nach Anspruch 1, wobei die Positionierungsanordnung
aus mindestens einem biokompatiblen Material hergestellt ist.
4. Knochenschnittpositionierungssystem nach Anspruch 1, wobei das femorale Befestigungselement
eine zweite Zunge (7) mit mindestens einer Befestigungsöffnung (8) enthält, die dazu
ausgelegt ist, einen Stift (28) zum Befestigen des femoralen Befestigungselements
an dem distalen Ende des Oberschenkelknochens aufzunehmen, wobei die mindestens eine
Befestigungsöffnung so ausgerichtet und positioniert ist, dass ein Befestigungspunkt
in die distale Trochlea des Oberschenkelknochens bereitgestellt wird.
5. Knochenschnittpositionierungssystem nach Anspruch 1, wobei das Lichtsendermontageelement
eine Lichtsenderaufnahmeöffnung (14) enthält, die dazu ausgelegt ist, mindestens einen
Teil des Lichtsenders aufzunehmen.
6. Knochenschnittpositionierungssystem nach Anspruch 5, ferner enthaltend eine magnetische
Schnittstelle, um den Lichtsender magnetisch an dem Lichtsendermontageelement zu befestigen.
7. Knochenschnittpositionierungssystem nach Anspruch 6, wobei der Lichtsender einen Magnetschalter
umfasst, der dazu ausgelegt ist, dazu aktiviert zu werden, den Lichtsender einzuschalten,
wenn er von dem Lichtsendermontageelement aufgenommen wird.
8. Knochenschnittpositionierungssystem nach Anspruch 1, wobei der Lichtsender einen Laserlichtsender
enthält.
9. Knochenschnittpositionierungssystem nach Anspruch 1, wobei das Führungselement eine
Einwegvorrichtung für einmaligen Gebrauch ist.
10. Knochenschnittpositionierungssystem nach Anspruch 1, wobei die Positionierungsanordnung
wiederverwendbar ist.
11. Knochenschnittpositionierungssystem nach Anspruch 1, ferner enthaltend einen Beuge-Streck-Indikator
(22).
12. Knochenschnittpositionierungssystem nach Anspruch 11, wobei der Beuge-Streck-Indikator
eine Wasserwaage enthält.
13. Knochenschnittpositionierungssystem nach Anspruch 1, wobei mindestens eines des Varus-Valgus
und der Beuge-Streck-Einstellelemente dazu ausgelegt ist, eine Einstellvorrichtung
aufzunehmen.
14. Knochenschnittpositionierungssystem nach Anspruch 1, wobei die erste Zunge dazu ausgelegt
ist, eine Referenz auf mindestens einer von einer medialen und lateralen Seite an
der vorderen Kortikalis des Oberschenkelknochens bereitzustellen.
15. Knochenschnittpositionierungssystem nach Anspruch 1, ferner umfassend:
eine magnetische Schnittstelle (18), die innerhalb des Kanals angeordnet ist, wobei
der Tiefenwählschieber dazu ausgelegt ist, innerhalb des Kanals durch die magnetische
Schnittstelle befestigt zu werden.
1. Système de positionnement de coupe d'os (11), comportant :
un ensemble de positionnement (10), comprenant :
un élément de fixation fémorale (2) conçu pour être fixé à une extrémité distale d'un
fémur, l'élément de fixation fémorale comprenant une première patte (4) dotée d'au
moins une ouverture de fixation (6) ;
un élément de montage d'émetteur de lumière (12) conçu pour recevoir un émetteur de
lumière (26) ;
un canal (16) ;
un élément de réglage de varus-valgus (20) conçu pour régler une position de l'ensemble
de positionnement par rapport au fémur de façon à obtenir un angle de varus-valgus
souhaité ; et
un élément de réglage de flexion-extension (24) conçu pour régler une position de
flexion-extension de l'ensemble de positionnement ; et
un élément de guidage (36), caractérisé en ce que la première patte est conçue pour une fixation au cortex antérieur du fémur proximal
à l'extrémité distale du fémur et en ce que l'élément de guidage est conçu pour un déploiement à partir d'un coulisseau sélecteur
de profondeur (38), le coulisseau sélecteur de profondeur étant conçu pour être reçu
à l'intérieur du canal de l'ensemble de positionnement, l'élément de guidage comprenant
au moins une surface de contact fémoral (44), le coulisseau sélecteur de profondeur
étant conçu pour se déplacer à l'intérieur du canal de façon à déplacer l'élément
de guidage de manière proximale-distale au fémur pour amener l'au moins une surface
de contact fémoral à coopérer avec l'extrémité distale du fémur afin de déterminer
un niveau de résection souhaité.
2. Système de positionnement de coupe d'os selon la revendication 1, dans lequel le coulisseau
sélecteur de profondeur est conçu pour un couplage magnétique avec le canal.
3. Système de positionnement de coupe d'os selon la revendication 1, dans lequel l'ensemble
de positionnement est fabriqué à partir d'au moins un matériau biocompatible.
4. Système de positionnement de coupe d'os selon la revendication 1, dans lequel l'élément
de fixation fémorale comprend une seconde patte (7) dotée d'au moins une ouverture
de fixation (8) conçue pour recevoir une broche (28) permettant de fixer l'élément
de fixation fémorale à l'extrémité distale du fémur, l'au moins une ouverture de fixation
étant orientée et disposée de façon à fournir un point de fixation dans la trochlée
distale du fémur.
5. Système de positionnement de coupe d'os selon la revendication 1, dans lequel l'élément
de montage d'émetteur de lumière comprend une ouverture de réception d'émetteur de
lumière (14) conçue pour recevoir au moins une partie de l'émetteur de lumière.
6. Système de positionnement de coupe d'os selon la revendication 5, comprenant en outre
une interface magnétique permettant une fixation magnétique de l'émetteur de lumière
à l'élément de montage d'émetteur de lumière.
7. Système de positionnement de coupe d'os selon la revendication 6, dans lequel l'émetteur
de lumière comprend un commutateur magnétique qui est conçu pour une activation permettant
d'alimenter l'émetteur de lumière lorsqu'il est reçu par l'élément de montage d'émetteur
de lumière.
8. Système de positionnement de coupe d'os selon la revendication 1, dans lequel l'émetteur
de lumière comprend un émetteur de lumière laser.
9. Système de positionnement de coupe d'os selon la revendication 1, dans lequel l'élément
de guidage est un dispositif jetable à usage unique.
10. Système de positionnement de coupe d'os selon la revendication 1, dans lequel l'ensemble
de positionnement peut être réutilisé.
11. Système de positionnement de coupe d'os selon la revendication 1, comprenant en outre
un indicateur de flexion-extension (22).
12. Système de positionnement de coupe d'os selon la revendication 11, dans lequel l'indicateur
de flexion-extension comprend un niveau à bulle.
13. Système de positionnement de coupe d'os selon la revendication 1, dans lequel au moins
l'un des éléments de réglage de varus-valgus et de flexion-extension est conçu pour
recevoir un dispositif de réglage.
14. Système de positionnement de coupe d'os selon la revendication 1, dans lequel la première
patte est conçue pour fournir une référence sur au moins l'un d'un côté médial et
d'un côté latéral du cortex antérieur du fémur.
15. Système de positionnement de coupe d'os selon la revendication 1, comprenant en outre
:
une interface magnétique (18) disposée à l'intérieur du canal, le coulisseau sélecteur
de profondeur étant conçu pour être fixé à l'intérieur du canal par l'interface magnétique.